Should the labouring woman have a choice of the instrument to be used on her?
There should be no problem with this, as long as she is well informed and both types of instruments are available and ideal for the circumstances. Of course, the operator must have the expertise in employing either.
What is the role of rotational forceps and ventouse?
Normally, in the course of labour, the baby’s head rotates in such a way that, by the time labour reaches second stage, the bay is facing down and towards the mother’s back (see images below). However, sometimes this does not happen and the baby’s back is towards the mother’s back. This is a very unfavourable position for delivery and, normally, for a normal-sized baby, spontaneous delivery may not be possible. However, vaginal delivery is still feasible if assistance using instruments is available.
Special type of forceps, called Kiellands are used for this. The blades of the forceps are locked on either side of the baby’s head and the rotation (which should have taken place naturally) effected. The baby is then in a normal favourable position and traction is applied to complete delivery. In trained hands, it is a very effective and safe instruments. Other obstetricians prefer using the ventouse to perform the rotation and subsequent delivery.
Would one say these instruments (forceps and ventouse) are safe?
Definitely. If and when used appropriately by a well-trained operator, these instruments are very safe and extremely useful. Every case where one of these is used for delivery is a potential caesarean section and the labouring woman on whom these have been used should consider herself "rescued" from a caesarean delivery.
Last Update: December 12, 2012